Delayed-Onset olanzapine-induced rhabdomyolysis.

Area of Science:

• Pharmacology
• Neurology
• Toxicology

Background:

• Olanzapine is a widely prescribed second-generation antipsychotic for schizophrenia, bipolar disorder, and dementia-related behavioral symptoms.
• While generally safe, serious adverse events are rare, with spontaneous rhabdomyolysis being an uncommon complication.

Observation:

• A patient on a stable olanzapine dose for over 8 years developed acute, severe rhabdomyolysis.
• The condition presented with delayed onset, lacked identifiable triggers, and showed no signs of neuroleptic malignant syndrome.

Findings:

• The patient exhibited an exceptionally high creatine kinase level (345,125 U/L), the highest reported in literature.
• This case details the clinical presentation of delayed-onset olanzapine-induced rhabdomyolysis.

Implications:

• Differentiating olanzapine-induced rhabdomyolysis from neuroleptic malignant syndrome is crucial for appropriate management.
• Prompt recognition and management are essential to prevent severe complications like acute kidney injury.